The Manchester Academic Health Science Centre · Chris Griffiths. Manchester Academic Health...

NHS-HE Forum

Manchester 24 November 2010

The Manchester Academic Health

Science Centre

Chris Griffiths

Manchester Academic Health Science Centre

Academic Health Science Centres

Why Manchester?

Vision

Structure

Goals

Achievements


A Virtuous Circle

Excellence in

Education

Improved Patient

Care

Excellence in

Research

DIFFUSION of

INNOVATION

Aneurin Bevan

5 July 1948

Park Hospital,

Trafford,

Manchester

The Birth of the NHS

Manchester

Why Now?

Examples of our health impact

Manchester

• Changed NHS practice in suicide prevention

• Changed policy in payment for general

medical services

• Demonstrated that dental screening

did not improve health

• Changed NHS practice with respect to

prevention of falls in the elderly

• Influenced NICE guidelines in management

of psychiatric illness, dentistry, stroke,

psoriasis and rheumatic disease

Clinical need

unmetClinical need

fulfilled

Excellent examples of

research publications

to ‘the world’

UK Leading Clinical Trials

capability but how many lead

to local change in clinical

practice before anyone else?

Excellent examples

of patient care &

innovation adoption

from ‘the world’

The dichotomy: we have some excellent research and patient care but some of the

worst health indicators in England

Translational Medicine

in Manchester – why?

Clinical need

unmetClinical need

fulfilled

Excellent examples of

research publications

to ‘the world’

UK Leading Clinical Trials

capability but how many lead

to local change in clinical

practice before anyone else?

Excellent examples

of patient care &

innovation adoption

from ‘the world’

The dichotomy: we have some excellent research and patient care but some of the

worst health indicators in England

Not enough translation of Manchester research findings to improve

Manchester/NW health and healthcare

Translational Medicine

in Manchester – why?

The Major Challenges

Integrating research and education with NHS service commitments

Avoiding duplication of effort and parochial decision-making

Making research infrastructure world-class and pan-Manchester

Reducing delay in the delivery of innovation

Bringing quality patient experience and outcome to the fore

Why Now?

• 2001: Wellcome Trust Clinical Research Facility

• 2004: Greater Manchester Research Alliance

• 2005: Manchester Cancer Research Centre

• 2006: NHS partners External Review of Research Strengths

• 2007: Greater Manchester Health Research project began

• 2008: MAHSC created; Company Limited by Guarantee

Darzi July 2008

Governance arrangements vary in U.S.

• Fully integrated; e.g. Johns Hopkins, Duke

• Cluster models; e.g. Stanford, Harvard

• Looser alliances; e.g. Yale

Elsewhere

• Full integration is more usual; Singapore


Imperial College Academic Health Sciences Centre

Imperial College London

Imperial College Healthcare NHS Trust

Cambridge University Health Partners

University of Cambridge

Cambridge University Hospitals NHS FT

Cambridgeshire and Peterborough NHS FT

Papworth Hospital NHS FT

5 Designated AHSCs March 2009

UCL Partners

University College London

University College London Hospital NHS FT

Great Ormond Street Hospital for Children NHS Trust

Moorfields Eye Hospital NHS FT

Royal Free Hampstead NHS Trust

King's Health Partners

King's College London

Guy's and Thomas's FT

King's College Hospital FT

Maudsley FT

MAHSC

Manchester Academic Health Science

Centre

University of Manchester

The Christie NHS FT

Central Manchester University Hospitals NHS FT

Mental Health & Social Care Trust

Salford Royal NHS FT

Salford Primary Care Trust

University Hospital of South Manchester NHS FT

£2.3 billion annual spend

35,000 people employed

7 Equal Partners

Diverse


Source: Research Fortnight

The University

RAE 2008, Strengths in Health-related Subjects

Cardiovascular medicine 4

Cancer studies 1

Primary care/community based clinical

subjects

2

Dentistry 1

Nursing and midwifery 1

Pharmacy 2

Biological sciences 3

Pre-clinical and human biological sciences 3

Quality RankUnit of Assessment


Christie: largest phase I/II cancer clinical

trials unit; co-located PET, MR imaging;

biomarkers; close industry partners

Mental Health: leads multi-site cohort studies in early adult psychosis;

six NIHR programme grants; National Drug Evidence Centre; first memory clinic

Central: Biomedical Research Centre

largest pregnancy research group in Europe

National Technology Adoption Centre

cardiovascular medicine

The Trusts


Salford PCT: award-winning research active

Primary Care Trust; lead for ten other

Manchester PCTs; emphasis on

implementation into clinical practice

Salford: expertise in linking electronic

records to health outcomes; quality

assessment; hub for stroke network;

shares R&D division with PCT

South: Translational Research Facility in respiratory medicine; heart/lung

transplantation; hosts CLRN; national aspergillosis centre

The Trusts

Our Partners


Strategic Health Authority

NICE

Industry

•U K Trade and Investment

•Astrazeneca

•GlaxoSmithKline

•ICON

AHSCs

•University of Pittsburgh

Medical Centre

•Nijmegen Medical centre

The Critical Path of Research


Platforms

Biomedical Research Centre

Manchester Cancer Research Centre

Wellcome Trust Clinical Research Facility

Biomedical Imaging Institute

Phase I Trials Facilities

NW E-Health

GM Comprehensive Local Research Network

Manchester Integrating Medicine with Innovative Technology

Collaboration for Leadership in Applied Health Research and Care

The Critical Path of Research

Education and Workforce DevelopmentHIEC

BRC

MIMIT

CLAHRC

e-Health

WT CRF

Phase I

MIB / FLS

WT Cell

BII / WMIC

MCRC

GM CLRN

NPCRDC

MIMIT

Glossary:

BRC - Biomedical Research

Centre

MCRC – Manchester Cancer

Research Centre

WT CELL - Wellcome Trust Centre for

Cell- matrix Research

MIB - Manchester Interdisciplinary

Biocentre

FLS - Faculty of Life Sciences

BII - Biomedical Imaging Institute

WMIC - Wolfson Molecular Imaging

Centre

Phase 1 – Phase 1 Clinical Trials Unit

WT CRF - Wellcome Trust Clinical

Research Facility

GM CLRN - Comprehensive Local

Research Network

e-Health (data management)

NPCRDC - National Primary Care R&D

Centre

CLAHRC - Collaboration for

Leadership in Applied Health

Research and Care

MIMIT - Manchester Integrating

Medicine and Innovative Technology

HIEC - Health Innovation and

Education Clusters

Goals

1. Improve the health and wellbeing of the population through the development and

application of innovative healthcare and research

2. Disseminate innovation in technology and care nationally and internationally.

3. Educate effectively in all aspects of healthcare, healthcare management, and

biomedicine in support of workforce development.

4. Lead on quality of care and public engagement.

5. Partner more widely and more beneficially with the commercial sector.

6. Contribute significantly to innovation, enterprise and economic development in the

city region and the North West of England.

7. Attract the best national and international health researchers and healthcare

workers.


Governance, Organisation and Management: a federated

approach with harmonisation of processes based on best

practice

Clinical Themes: leading capabilities combined with strong

communication and cross working across the translational

medicine spectrum

Enabling Infrastructure: pan-MAHSC resource and alignment

with national programmes supported by fully trained staff

Building Blocks

Governance and

Management

Blue represents staff part or whole funded by MAHSC

Company Limited by Guarantee

MAHSC Board of

Governors6 NHS Chief Executives,

University President,

Director,

3 Non-Executives

Director

MAHSC Executive

Management TeamDirector,

Chief Operating Officer,

Clinical and Enabling

Academic Section Heads,

6 Trust Medical Directors,

University representative

Chief Operating

Officer

MAHSC Office PA

Research Operations

Manager

Enabling Academic

Section HeadsInfrastructure &

Technology,

Evaluation,

Implementation & Health of

the Public

Education & Training

Clinical Academic

Section HeadsCancer,

Cardiovascular,

Human Development,

Inflammation & Repair,

Mental Health MAHSC Research

Operations GroupResearch Operations

Manager

Heads of R&D Offices,

GM CLRN


Cancer

Cardiovascular

Human Development

Mental Health

Inflammation and Repair

Evaluation

CLRN interface

Biostatistics

Bio-health

informatics and

epidemiology

Infrastructure

and technology

DNA banks

Tissue banks

-omics

Imaging

e-Health

Postgraduate

Integrated

academic

training

programme

Education

and

training

Clinical

Academic

Sections

Enabling Academic Sections

Structured for Delivery

NEED

UNMETNEED

FULFILLED

Health economics

Health services

Primary care

Quality assessment

Health inequalities

Implementation

and Health of the

Public

Strategic plan: from our five year vision

E-health

• e-Lab infrastructure gives access to anonymised linked records from all

aspects of NHS care for a population of 2.5 m

Clinical trials

• An integrated facility across the partners accessible via single portal

enabling studies from biomarker and first-in-man to population level

interventions

Implementation

• Implementation embedded in the organisation through knowledge

transfer agents

e-Enablement Assets

North West Institute for BioHealth Informatics (NIBHI) is lead asset.

Current assets include :

Salford and Wirral e-Lab Pilot Studies: e-care records linked across primary and secondary care in Salford (220K) and Wirral (330K)

Obesity Epidemiology and Public Health Informatics/Obesity e-Lab: focus on research & new insights into obesity epidemic and public health measures to tackle it

An MRC-funded project (IMPACT) fusing informatics, epidemiology and economics - scenario planning for health policy, initially cardiovascular

e-Health+: research cluster/network to enable a more citizen-led approach to improving health

Infrastructure

and technology

DNA banks

Tissue banks

-omics

Imaging

e-Health

FEDERATION OF

AHSCs IN UK,

INTERNATIONAL

LINKAGE

Cancer

Cardiovascular

Human development

Mental health

Inflammation and repair

Evaluation

CLRN interface

Biostatistics

Bio-health

informatics and

epidemiology


Infrastructure

and technology

DNA banks

Tissue banks

-omics

Imaging

e-Health

FEDERATION OF

AHSCs IN UK,

INTERNATIONAL

LINKAGE

Cancer

Cardiovascular

Human development

Mental health

Inflammation and repair

Evaluation

CLRN interface

Biostatistics

Bio-health

informatics and

epidemiology


MAHSC FIVE YEAR KPIs

Delivery of e-enabled population database of ≥

2.5M (anonymised linked records).

Delivery of a co-ordinated bio-repository

across MAHSC members

Clinical Trials Approach

Project Current Status Required MAHSC KPIs

Clinical Trials Coordination Unit (CTCU)

Proposal to the Board 22 July Funding for enhancing resource to support an NIHR registered Christie CTCU to deliver Manchester wide service 28, 2, 3

Joint Research Office Review for the Board 22 July Process harmonisation, SOPs (ongoing), Co-location of University/NHS staff. A dedicated Clinical Trials Office working looselywith GMCLRN with the Research Office. Development of Detailed plan to be worked up by MAHSC R&D Directors Group.

25, 26, 15,16

Coordinated Clinical Trials Research Facilities

Working Group structure identified

Working Group initiation awaits outcome of strategic review on Wellcome Trust Clinical Research Facility by Steering Committee under new Chair, Dr John Stageman.

2.3, 15, 16

E-enabled trials feasibility and recruitment systems

GMCLRN working on FARSITE programme with NWeH

Pilot development utilising 5 GP practices in Salford underway. Approval for whole of Salford in place (~60 practices). Stage 2 will recruit further 29 Greater Manchester practices already aligned with GMCLRN [by end of stage 2 this will encompass total population of ~500 000]

3, 29

Research and Innovation Culture

1% clinicians leading research

10% clinicians engaged in research

100% clinicians supporting research

Strategic plan: from our ten year vision

• More than 10 demonstrable health benefits

• More than 100 new senior national/international health researchers

• More than 1,000 research-enabled healthcare workers trained

• Trebled commercial partnerships in drugs and devices

• Health-conscious population of "citizen scientists” created

What have we done so far?

Pilot Projects

Citizen ScientistsEncourage, inspire and support the public, especially the local community, to engage in

research activity in order to improve recruitment to trials in the first instance.

Development a cadre of citizen scientists who support the needs of clinical research.

MIMIT Industrial Liaison Programme (SMEs) Access to industry partners to deliver developed technology in response to unmet need (highlighted

by MIMIT partnered clinicians)

Source of potential partners for collaborative funding bids

Development of marketable technologies that deliver patient benefit

Co-Morbidity Biobanking Work on data links, public engagement and access will address central aims of MAHSC

communications and harmonisation.

Building of a regional hub and spoke structure to develop resource to test hypotheses in co-

morbidity eg diabetes and cardiovascular disease

Demonstrator for European project

What have we done so far ?

Harmonisation

Research costing Will enable accurate, consistent and transparent costing and inclusion of all party costs

ContractsWill eliminate time wasted through negotiation of non-standard contracts

Reporting and Management Information Will enable identification of cross-institutional projects and provide data against research KPIs.

Establishing R&D Office Key Performance Indicators (KPIs) To ensure all R&D teams work to same standard and timescales

MAHSC Research OfficeApproval for virtual co-located R&D Office

Successes

MRC Clinical Research Training Fellowship Programme in Clinical

Pharmacology (with Liverpool)

OLS Clusters: Inflammatory Respiratory Disease & Joint and

Related Inflammation

Proton Beam Therapy Centre with UCL Partners and Birmingham

Modernising Scientific Careers Early Adopter site

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